Individual
JACOB DUANE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2725 SW CEDAR HILLS BLVD STE 2A, BEAVERTON, OR 97005-1344
(503) 352-6000
(503) 434-8597
Mailing address
PO BOX 6149, ALOHA, OR 97007-0149
(503) 359-8501
(503) 434-8597
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA185067
OR
Other
Enumeration date
12/01/2017
Last updated
02/11/2019
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